Sistema de Salut de Catalunya
Institut Català de la Salut
[Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. [Acharya S, Aggarwal B] Emerging Markets, GlaxoSmithKline, Singapore. [Fernandes FLA] Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. [Dreyse J] Internal Medicine and Critical Care Center Departments, Clínica Las Condes and School of Medicine, Universidad Finis Terrae, Santiago, Chile. [Jardim JR] Respiratory Division, Escola Paulista de Medicina, Federal University of São Paulo, Sao Paulo, Brazil
Vall d'Hebron Barcelona Hospital Campus
2023-09-19T08:59:55Z
2023-09-19T08:59:55Z
2023-08-28
COPD exacerbations; Delphi procedure; Triple inhaled therapy
Exacerbacions de MPOC; Procediment Delphi; Teràpia triple inhalada
Exacerbaciones de la EPOC; Procedimiento Delphi; Terapia triple inhalada
Purpose: Role of triple therapy in chronic obstructive pulmonary disease (COPD) management is supported by growing evidence, but consensus is lacking on various aspects. We conducted a Delphi survey in respiratory experts on the effects of triple therapy on exacerbation reduction, early optimization, pneumonia risk, and mortality benefits in COPD management. Methods: The study comprised 2-round online surveys and a participant meeting with 21 respiratory experts from 10 countries. The 31-statement questionnaire was prepared using Decipher software after literature review. Responses were recorded using Likert scale ranging from 1 (disagreement) to 9 (agreement) with a consensus threshold of 75%. Results: All experts participated in both surveys and 14/21 attended participant meeting. Consensus was reached on 13/31 questions in first survey and 4/14 in second survey on: mortality benefits of triple therapy; comparable pneumonia risk between single inhaler triple therapy (SITT) and multiple inhaler triple therapy (81%); preference of SITT for patients with high eosinophil count (95%); exacerbation risk reduction and healthcare cost benefits with early initiation of SITT post exacerbation-related hospitalization (< 30 days) (86%). No consensus was reached on first line SITT use after first exacerbation resulting in COPD diagnosis (62%). Conclusion: This study demonstrated that there is consensus among experts regarding many of the key concepts about appropriate clinical use and benefits of triple therapy in COPD. More evidence is required for evaluating the benefits of early optimisation of triple therapy.
This study was funded by GSK. Meetings, data analysis, and medical writing assistance were funded by GSK.
Article
Published version
English
Pulmons - Malalties obstructives - Tractament; Decisió de grup; INFORMATION SCIENCE::Information Science::Systems Analysis::Delphi Technique; DISEASES::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive; Other subheadings::Other subheadings::Other subheadings::/drug therapy; PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus; CIENCIA DE LA INFORMACIÓN::Ciencias de la información::análisis de sistemas::técnica Delfos; ENFERMEDADES::enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica; Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia; PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso
Dove Medical Press
International Journal of Chronic Obstructive Pulmonary Disease;18
https://doi.org/10.2147/COPD.S424128
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
Articles científics - HVH [3436]
Articles científics - VHIR [1664]
